Chapter 30 ■ Umbilical Vein Catheterization 177

Fig. 30.5. A: Radiograph showing venous catheter that has crossed the ductus arteriosus into the thoracic aorta. B: In this situation, the arterial pressure markings were not helpful because the presence of

pulmonary hypertension in the patient rendered the tracings from the pulmonary artery and descending

aorta virtually identical.

B

A

d. Hemorrhagic infarction of lung (7)

e. Hydrothorax (catheter lodged in or perforated pulmonary vein) (22)

4. Catheter malpositioned in portal system

a. Necrotizing enterocolitis (23,24)

b. Perforation of colon (25)

c. Hepatic necrosis (thrombosis of hepatic veins or

infusion of hypertonic or vasospastic solutions into

liver tissues) (Fig. 30.7) (11,12,17,26)

d. Hepatic cyst (27)

e. Ascites (secondary to extravasation of fluid through

malpositioned catheter) (28)

f. Hepatic laceration (29)

5. Other

a. Perforation of peritoneum (30)

b. Obstruction of pulmonary venous return (in

infant with anomalous pulmonary venous drainage)

(1)

c. Plasticizer in tissues (31)

d. Portal hypertension (16,32)

e. Electrical hazard (see Chapter 29, J3c) (2)

f. Fungal mass in right atrium (33)

g. Pseudomass in left atrium (34)

h. Digital ischemia (35)

i. Pneumopericardium (36)